This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Elevated serum free fatty acid (FFA) levels are common in people at risk for cardiometabolic syndrome. These FFA are transported, converted, and stored as monoglycerides, diglycerides, and triglycerides in nonadipose tissues including liver, skeletal muscle, and heart. For the heart, this lipid accumulation has been associated with insulin resistance, diabetes, systolic dysfunction, and in animal models, apoptosis.1[unreadable]7 However, the relationship between FFA, cardiometabolic syndrome, and cardiovascular disease is unclear and the correlations imperfect. In contrast to FFA levels, a direct measure of cardiac intramyocellular lipid (IMCL) content provides a clear indicator of ectopic lipid accumulation and may provide a better risk predictor for disease. Here we describe and demonstrate a 1H magnetic resonance spectroscopy (MRS) technique for quantifying human myocardial lipid content.